The effect of l-arginine supplementation and surgical trauma on the frequency of myeloid-derived suppressor cells and T lymphocytes in tumour and blood of colorectal cancer patients.

PURPOSE: l-arginine (L-arg) deficiency causes immunosuppression, but it is unknown if L-arg supplementation in colorectal cancer (CRC) patients restores immune system activity. Our objective was to investigate the effect of L-arg supplementation on the frequency of monocytic (M) and polymorphonuclear (PNM) myeloid-derived suppressor cells (M-MDSCs and PMN-MDSCs, respectively). METHODS: We enrolled 65 CRC patients (34 males, 31 females) aged 69 â€‹± â€‹10 years into a prospective, randomised, double-blind study. Twenty-eight patients received L-arg and 37 received placebo for 9 days at a dose of 10 â€‹g/day. The frequency changes in MDSC, CD4+ cells and the concentration of C-reactive protein (CRP) were assessed before supplementation with L-arg (test 1), after 9 days of supplementation (test 2), and after surgery on day 11 (test 3). RESULTS: The frequency of M-MDSC in the tumours of patients receiving L-arg supplementation was higher than in placebo-treated patients, as was the frequency of PMN-MDSC and M-MDSC in the mucosa. CRP concentration in the serum of placebo-treated patients in test 2 was higher than in test 1, and the concentration in the serum of patients with L-arg supplementation in test 2 was lower than in test 1. Moreover, the expression pattern of the argininosuccinate synthase 1 (ASS1) suggests that CRC is not auxotrophic for L-arg. CONCLUSIONS: The results of this study do not support the hypothesis that L-arg supplementation in CRC patients can reduce immunosuppression by decreasing the frequency of suppressor cells and increasing the frequency of effector CD4+ T cells.

Functional assessment of the right ventricle in patients with bronchial asthma of various severity.

INTRODUCTION: Pulmonary artery hypertension and its consequences still constitutes an underestimated clinical problem in asthma patients and its non-invasive early detection may influence proper treatment. AIM: To non-invasively examine the pulmonary artery flow parameters and right ventricular function in patients with asthma of various severity. MATERIAL AND METHODS: The analysis of parameters of echocardiography and first-pass and gated radionuclide angiography, and baseline examination in 31 patients with bronchial asthma and 16 healthy controls. RESULTS: Patients with severe asthma had higher mean pulmonary artery pressure (MPAP) compared to the healthy controls. The subgroup analysis of patients who suffered from asthma in their childhood showed that individuals with severe asthma were characterized by significantly higher MPAP than those with the mild/moderate condition (19.16 ±7.51 mm Hg vs. 5.0 ±1.15 mm Hg, p = 0.025). Gated, but not first-pass, radionuclide angiography revealed that individuals with severe asthma were characterized by a lower right ventricular ejection fraction (RVEF). Further analysis of the subgroup of patients in whom the initial manifestation of dyspnoea occurred no earlier than 6 years prior to the study showed that the RVEF of individuals with severe asthma was significantly lower compared to those with mild/moderate asthma (39.8 ±4.79% vs. 51.4 ±8.65%, p = 0.019). CONCLUSIONS: The pulmonary artery pressure in patients with severe asthma is significantly higher than in healthy individuals; in contrast, these two groups did not differ significantly in terms of the right ventricular echocardiographic characteristics. Gated radionuclide angiography, but not the first-pass technique, allowed for the detection of subtle right ventricular ejection fraction changes in asthma patients.

Sex-related differences among ischaemic stroke patients treated with intravenous thrombolysis in Poland.

AIM OF STUDY: We investigated sex differences i n i schaemic s troke p atients t reated w ith i ntravenous a lteplase. CLINICAL RATIONALE FOR STUDY: We suggest that it is necessary to improve care for women with atrial fibrillation. Our data suggests that closer evaluation of treatment for ischaemic stroke in men and women is needed, preferably in the form of a prospective study. MATERIALS AND METHODS: This was a multicentre analysis of 1,830 ischaemic stroke patients treated with alteplase from 2004 to 2012. Data was prospectively collected in the Safe Implementation of Treatments in Stroke (SITS) registry. The main outcome measures were symptomatic intracerebral haemorrhage (sICH) within 36 hours of treatment, three months of functional independence, and mortality. RESULTS: Women were significantly older (mean age 71.3 vs 66.2 years; p < 0.01), more often suffered from hypertension (78.3% vs 70.1%; p < 0.01) and cardio-embolic strokes (34.7% vs 27.1%; p < 0.01), and presented heavier baseline deficits. There were no differences in sICH, but after three months fewer women were functionally independent (46.5% vs 53.3%; p < 0.01) and women had higher mortality (26.0% vs 19.7%; p < 0.01). CONCLUSIONS: Of the ischaemic stroke patients treated with intravenous thrombolysis, women had worse long-term outcomes than men. This discrepancy may be explained by the older age and higher proportion of cardio-embolic strokes with more severe baseline deficits. However, multiple logistic analysis did not show that sex itself had an impact on the greater mortality in women after a stroke, or on the poorer prognosis.

Coincidence of PTPN22 c.1858CC and FCRL3 -169CC genotypes as a biomarker of preserved residual ß-cell function in children with type 1 diabetes.

BACKGROUND: Genotype-phenotype studies in type 1 diabetes (T1DM) patients are needed for further development of therapy strategies. OBJECTIVE: Our aims were to investigate the distribution of selected PTPN22 and FCRL3 gene polymorphisms and their associations with clinical course of disease in children with newly diagnosed T1DM from the Pomeranian region of Poland. SUBJECTS/METHODS: The prospective, longitudinal study of 147 children with newly diagnosed T1DM-autoimmune subtype was conducted. The PTPN22 c.1858T>C (rs2476601) and FCRL3 -169C>T (rs7528684) polymorphisms were analyzed using polymerase chain reaction-restriction fragment length polymorphism method (PCR-RFLP) and DNA sequencing. The frequencies of genotypes were compared between the study and population-matched control group (327 random anonymous samples from the Pomeranian region). Selected patients underwent a 24-monthly follow up [periodic re-evaluation of fasting C-peptide concentration (FCP) and hemoglobin A1c (HbA1c ) level]. RESULTS: A significantly lower coincidence of the PTPN22 c.1858CC and FCRL3 -169CC genotypes was found in the study group compared with controls (P = 0.04). The PTPN22 c.1858CC and FCRL3 -169CC genotype combination, restricted to female patients only, was associated with well-preserved residual ß-cell function throughout the entire follow up (prolonged FCP level increase up to the sixth month of disease, with further very stable dynamics-FCP median level ≥0.67 ng/mL without significant decrease up to the 24th month). HbA1c levels in this subgroup also remained the lowest during the observation period. CONCLUSIONS/INTERPRETATION: Ascertained phenomenon could be explained by an interacting mechanism of the two polymorphisms through estrogen-regulated nuclear factor kappa B signaling in regulatory T (Treg ) lymphocytes. This hypothesis, if confirmed, may lead to further development of Treg administration-based therapies.

Reorganization of nutritional therapy can markedly reduce the rate of catheter-related blood stream infections in pediatric patients receiving parenteral nutrition - a 7-year prospective follow-up study / Cambio de la organización del tratamiento nutricional puede reducir considerablemente la tasa de bacteriemia asociada al catéter (BAC) en pacientes pediátricos que reciben nutrición parenteral, un estudio prospectivo de seguimiento de 7 años de duración

Antecedentes: La implementación de medidas higiénicas y cambios sencillos en la estructura del personal médico puede reducir considerablemente la tasa de bacteriemia asociada al catéter (BAC) en pacientes que reciben nutrición parenteral. Objetivo: Analizar el impacto de los cambios organizacionales dentro de los servicios de nutrición parenteral sobre las tasas de BAC en pacientes pediátricos. Métodos: Hemos comparado las tasas de BAC documentadas antes, durante y después de la implementación de los cambios organizacionales (introducción de un grupo de apoyo nutricional y los procedimientos relacionados, formación del personal médico). Descubrimientos: Un total de 260 series de nutrición parenteral fueron ofrecidos a 141 pacientes pediátricos durante el periodo analizado. Se documentaron treinta BAC durante este periodo. Los factores etiológicos más frecuentes eran staphylococci (21/30), seguidos por Klebsiella pneumoniae, Escherichia coli y Candida albicans (2/30 cada uno). Los cambios organizacionales fueron reflejados en una reducción de la incidencia de BAC en más de 8 veces: el valor inicial disminuyó desde 10.14 hasta 6.89 por 1000 días-catéter y hasta 1.17 por 1000 días-catéter durante y después de la reorganización, respectivamente. Conclusión: La introducción de un grupo de apoyo nutricional, acompañada de una extensa formación del personal médico puede resultar en una reducción considerable de la tasa de BAC en pacientes pediátricos que reciben nutrición parenteral en en un entorno hospitalario (AU)

Background: Implementation of hygienic measures and simple changes in the structure of medical team may considerably reduce the rate of catheter-related blood stream infections (CRBSIs) in parenterally nourished patients. Aim: To analyze the effects of organizational changes in parenteral nutrition services on the CRBSI rates in pediatric patients. Methods: We compared the CRBSI rates documented prior to, during and after the implementation of the organizational changes (introduction of a nutritional support team and related procedures, medical staff training). Findings: A total of 260 courses of parenteral nutrition were offered to 141 pediatric patients during the analyzed period. Thirty CRBSIs were documented during this period. The most frequent etiological factors were staphylococci (21/30), followed by Klebsiella pneumoniae, Escherichia coli and Candida albicans (2/30 each). The reorganization was reflected by more than8-fold reduction of the CRBSI incidence rate: from the initial value of 10.14 to 6.89 per 1000 catheter days and1.17 per 1000 catheter days during and after the reorganization, respectively. Conclusion: Introduction of a nutritional support team, accompanied by extensive training of medical staff, can result in a marked reduction of CRBSI rate in pediatric patients nourished parenterally in a hospital setting (AU)

Reorganization of nutritional therapy can markedly reduce the rate of catheter-related blood stream infections in pediatric patients receiving parenteral nutrition - a 7-year prospective follow-up study.

BACKGROUND: Implementation of hygienic measures and simple changes in the structure of medical team may considerably reduce the rate of catheter-related bloodstream infections (CRBSIs) in parenterally nourished patients. AIM: To analyze the effects of organizational changes in parenteral nutrition services on the CRBSI rates in pediatric patients. METHODS: We compared the CRBSI rates documented prior to, during and after the implementation of the organizational changes (introduction of a nutritional support team and related procedures, medical staff training). FINDINGS: A total of 260 courses of parenteral nutrition were offered to 141 pediatric patients during the analyzed period. Thirty CRBSIs were documented during this period. The most frequent etiological factors were staphylococci (21/30), followed by Klebsiella pneumoniae, Escherichia coli and Candida albicans (2/30 each). The reorganization was reflected by more than 8-fold reduction of the CRBSI incidence rate: from the initial value of 10.14 to 6.89 per 1000 catheter days and 1.17 per 1000 catheter days during and after the reorganization, respectively. CONCLUSION: Introduction of a nutritional support team, accompanied by extensive training of medical staff, can result in a marked reduction of CRBSI rate in pediatric patients nourished parenterally in a hospital setting.

Antecedentes: La implementación de medidas higiénicas y cambios sencillos en la estructura del personal médico puede reducir considerablemente la tasa de bacteriemia asociada al catéter (BAC) en pacientes que reciben nutrición parenteral. Objetivo: Analizar el impacto de los cambios organizacionales dentro de los servicios de nutrición parenteral sobre las tasas de BAC en pacientes pediátricos. Métodos: Hemos comparado las tasas de BAC documentadas antes, durante y después de la implementación de los cambios organizacionales (introducción de un grupo de apoyo nutricional y los procedimientos relacionados, formación del personal médico). Descubrimientos: Un total de 260 series de nutrición parenteral fueron ofrecidos a 141 pacientes pediátricos durante el periodo analizado. Se documentaron treinta BAC durante este periodo. Los factores etiológicos más frecuentes eran staphylococci (21/30), seguidos por Klebsiella pneumoniae, Escherichia coli y Candida albicans (2/30 cada uno). Los cambios organizacionales fueron reflejados en una reducción de la incidencia de BAC en más de 8 veces: el valor inicial disminuyó desde 10.14 hasta 6.89 por 1000 días-catéter y hasta 1.17 por 1000 días-catéter durante y después de la reorganización, respectivamente. Conclusión: La introducción de un grupo de apoyo nutricional, acompañada de una extensa formación del personal médico puede resultar en una reducción considera ble de la tasa de BAC en pacientes pediátricos que reciben nutrición parenteral en en un entorno hospitalario.

Maternal smoking modulates fatty acid profile of breast milk.

AIM: We hypothesized that the fatty acid composition of breast milk can be affected by a smoking habit in the mother. Consequently, this study verified whether maternal smoking modulates, and if so to what extent, the breast milk fatty acid profile. METHODS: The study included 20 postpartum women who declared smoking more than five cigarettes daily throughout a period of pregnancy and lactation, and 136 nonsmoking postpartum women. Breast milk samples were collected between the 17th and the 30th day after delivery. The samples were analysed by means of high-resolution gas chromatography for overall content of saturated, monounsaturated and polyunsaturated fatty acids. RESULTS: Compared with nonsmokers, smokers were characterized by significantly higher relative breast milk contents of fatty acids and monounsaturated fatty acids. Additionally, smokers' breast milk had higher concentrations of selected saturated fatty acids, monounsaturated fatty acids and polyunsaturated fatty acids. Furthermore, smokers were characterized by significantly lower values of linoleic to arachidonic acid ratio and n-6 to n-3 polyunsaturated fatty acids ratio. CONCLUSIONS: Aside from its other harmful consequences, smoking modulates the fatty acid profile of human milk.

Anxiety disorders in intimate partners and the quality of their relationship.

BACKGROUND: The aim of this study was to explain whether anxiety disorders presenting in one or both partners of a relationship can influence the latter and to what extent. METHODS: This study included 85 couples, where: 1) the male partner suffered from an anxiety disorder and female partner was free from this type of disorder (F((-))M((+)), n=20); 2) the female partner suffered from an anxiety disorder and the male partner was free from this type of disorder (F((+))M((-)); n=40); and 3) both partners were affected with anxiety disorders (F((+))M((+)), n=25). The quality of the relationship was assessed by both partners using three different scales: 1) Dyadic Adjustment Scale (DAS), 2) Family Attitude Scale (FAS), and 3) Marriage Success Scale (SPM). RESULTS: In case of the SPM scale, women from F((-))M((+)) group evaluated their marriages significantly compared to other groups. In case of males, the self-evaluated quality of marriage was the lowest in the case of individuals from F((+))M((+)) group. In case of the DAS scale, women and men being free from anxiety disorders assessed the quality of their relationships significantly higher than other participants. The analyzed groups did not differ significantly in terms of mean values scored in the FAS scale. LIMITATIONS: The lack of a multifactorial analysis taking into account the effects of a variety of anxiety disorders. CONCLUSION: The presence of anxiety disorders in at least one partner negatively affects the quality of partner relationship. The couples where the female partners are affected are particularly fragile.

Application of adjusted subpixel method (ASM) in HRCT measurements of the bronchi in bronchial asthma patients and healthy individuals.

BACKGROUND: Recently, we described a model system which included corrections of high-resolution computed tomography (HRCT) bronchial measurements based on the adjusted subpixel method (ASM). OBJECTIVE: To verify the clinical application of ASM by comparing bronchial measurements obtained by means of the traditional eye-driven method, subpixel method alone and ASM in a group comprised of bronchial asthma patients and healthy individuals. METHODS: The study included 30 bronchial asthma patients and the control group comprised of 20 volunteers with no symptoms of asthma. The lowest internal and external diameters of the bronchial cross-sections (ID and ED) and their derivative parameters were determined in HRCT scans using: (1) traditional eye-driven method, (2) subpixel technique, and (3) ASM. RESULTS: In the case of the eye-driven method, lower ID values along with lower bronchial lumen area and its percentage ratio to total bronchial area were basic parameters that differed between asthma patients and healthy controls. In the case of the subpixel method and ASM, both groups were not significantly different in terms of ID. Significant differences were observed in values of ED and total bronchial area with both parameters being significantly higher in asthma patients. Compared to ASM, the eye-driven method overstated the values of ID and ED by about 30% and 10% respectively, while understating bronchial wall thickness by about 18%. CONCLUSIONS: Results obtained in this study suggest that the traditional eye-driven method of HRCT-based measurement of bronchial tree components probably overstates the degree of bronchial patency in asthma patients.

Longitudinal study of vitamins A, E and lipid oxidative damage in human milk throughout lactation.

BACKGROUND: Little is known about the intensity of oxidative damage in human milk resulting from maternal oxidative stress. The aim of our study was to explore the changes in Total Antioxidant Status (TAS) and concentrations of antioxidative vitamins and isoprostanes (markers of oxidative stress) in human colostrum and mature milk. METHODS: The study included 49 postpartum women with normal, spontaneous full term delivery. The exclusion criteria included active and passive smoking, acute and chronic disorders, and pharmacotherapy other than vitamin supplementation. Colostrum samples were collected on the 3rd day after delivery and breast milk samples between the 30th and the 32nd day after delivery. TAS of colostrum/breast milk was determined by Rice-Evans and Miller method. The amount of vitamins A and E was measured by HPLC. Isoprostane concentrations in colostrum/mature milk and urine were determined immunoenzymatically. RESULTS: No significant differences were observed in maternal dietary intakes of vitamins A and E determined prior to the colostrum and mature milk sampling. The TAS of mature milk was significantly higher compared to colostrum (P=0.002), while vitamin A and E concentrations were significantly lower (P=0.003 and P=0.001). Although the isoprostane concentration of mature milk was significantly higher than the colostrum concentration, this difference was not significant (P=0.129). CONCLUSION: Human milk is a source of antioxidative vitamins and their concentrations decrease throughout the lactation, while their total antioxidative properties increase. The phase of lactation does not affect the degree of human milk's lipid oxidative damage.

[Reliability of self-reported maternal smoking during early lactation period]. / Ocena wiarygodnosci badan ankietowych dotyczacych palenia tytoniu przez kobiety we wczesnym okresie laktacji.

UNLABELLED: Smoking cigarettes is very common among lactating women. The objective evaluation of an exposure to cigarette smoke is needed, as cotinine concentration. On many research a questionnaire is the only determinant of fact and intensification of smoking. The aim of this research was to establish a reliability of the questionnaire concerning cigarette smoking among lactating mothers by analyzing cotinine/creatinine ratio. MATERIAL AND METHODS: In 51 lactating mothers (participants of the research on oxidative stress in Obstetrics Departments on 3rd day post partum) during check-up visit, on 30th day post partum a questionnaire concerning smoking cigarettes before, during pregnancy and after childbirth, and amount of cigarettes smoked was made. Samples of matutinal urine were deep freezed in - 700 till cotinine was evaluated immunoenzymatically. Women were divided into groups: I of non-smokers (32 women), II of smokers (19 women). Statistical analysis was made by means of unparametric test U Mann-Whitney. RESULTS: Average cotinine/creatinine ratio was 33,8 ng/mg in group I; 1275.9 ng/mg in group II. Specificity and sensitivity of data earned by virtue of statement of correspondents was 81% and 89%. Test of cotinine concentration in urine demonstrated 100% sensitivity and 94% specificity compared to the cotinine/creatinine ratio. Directly proportional relationship was stated between amount of cigarette smoked and concentration of cotinine in urine (55.9 ng/ ml cotinine/cigarette). CONCLUSIONS: A questionnaire should not be the only method evaluating smoking among lactating women. The concentration of cotinine shows slightly lower specificity than cotinine/creatinine ratio. Both tests can be dealt equivalent.

TGF-beta(1), IL-10 and IL-4 in colostrum of allergic and nonallergic mothers.

OBJECTIVE: To determine transforming growth factor (TGF) beta(1), interleukin (IL) 4, and IL-10 concentrations in human milk and to assess the relationship between allergic disorders in mothers and the content of the interleukins in their milk. MATERIAL AND METHODS: Thirty allergic and 46 healthy mothers were included in the study. Colostrum was collected 2-3 days after delivery. Cytokine concentrations were determined with commercial enzyme-linked immunosorbent systems. RESULTS: TGF-beta(1)was found in milk from 23 women in the control group (53.49%) and 11 in the allergy group (37.93%). When TGF-beta(1) was present, the median concentration was higher in the allergy group than in the control (61.5 and 30.4 pg/mL, respectively; P < 0.004). IL-10 was present in the colostrum of all the women and the median IL-10 concentration did not differ between the allergy (50.5 pg/mL) and control (51.5 pg/mL) groups. The probability of occurrence of a positive IL-4 value in the allergy group was greater than in the control group (chi-squared [df=1] = 2.60, P < 0.053). Median IL-4 level did not differ significantly between the two groups (0.5 and 0.5 pg/mL respectively). CONCLUSIONS: TGF-beta(1) was detected less often in the colostrum of allergic mothers than in that of mothers without allergy (but the difference was not statistically significant). IL-4 was found more often in the colostrum of allergic mothers than nonallergic ones. The allergy status did not correlate with IL-10 concentration.

[The comparison of selected spirometric parameters with functional muscles exercise evaluation in patients with myasthenia]. / Porównanie wybranych parametrów spirometrycznych z funkcjonalna ocena wysilkowa miesni u chorych na miastenie.

UNLABELLED: Pathological skeletal muscle weakness is an axial clinical symptom of myasthenia (MG). Diminished respiratory muscular force can be manifested by decreased peak expiratory flow (PEF) value. MATERIAL AND METHODS: Patients aged 13-77 years were studied at which according to Osserman classification ocular form (the type I) or generalized form (the type II) was diagnosed (n = 68). PEF and FVC values such as % of predicted value (PV) obtained in "flow-volume" measure were analysed. The trunk and extremities muscles force was estimated according to Besinger. RESULTS: Weakness of lower extremities muscles was found at all examined subjects. Positive result of trunk muscle test was found in 69% of patients with type I and 89% with type II. In type II upper extremities muscles (UEM) weakness was observed more often than in type I (74% subjects vs. 31%). In both types of MG the mean value of PEF was lower in patients with UEM weakness and amounted 89.5% vs. 112.4% in type I and 87.4% vs. 100.4% in type II. In type I the mean value of FVC was lower in patients with UEM weakness than in patients without symptoms (83.7% vs. 106.2%), with trunk muscles weakness (93.8% vs. 111.7%) and in patients with decreased muscles force up to 15% (87.5% vs. 106.7%). In this type of MG decreased value of FVC < 80% PV was observed in 50% of patients with UEM weakness and in 40% of patients with decreased muscles force up to 15%, but at none of subjects without symptoms in above tests. CONCLUSIONS: In patients with myasthenia of type I and II the weakness of upper extremities muscles correlates with decreased PEF value in spirometry. In addition in ocular myasthenia decreased FVC value was observed more often in patients with positive results of test of the functional muscles estimation.

[Etiology of community - acquired acute diarrhea in children]. / Etiologia ostrych biegunek pozaszpitalych u dzieci.

THE AIM: of the study was to analyse the etiology of home acute diarrhea in children. MATERIAL AND METHODS: 2636 children with community-acquired acute diarrhea were included in the study. Stool samples were analysed for the presence of Salmonella spp, Shigella spp, rotaviruses and adenoviruses. RESULTS: etiology of acute diarrhea was established in 1149 out of 2636 children (43.6%). Among the children with known etiology - rotaviral diarrhea was most frequently diagnosed (24.67%), whereas salmonellosis - in 7.06% of cases, EPEC C - 6.37%, EPEC B - 2.92%, EPEC A - 1.89%, adenoviral diarrhea in 0.68%. Mean age of children with bacterial acute diarrhea (Salmonella, EPEC A, B, C) was higher as compared to the mean age of children with rotaviral acute diarrhea (p < 0.002). Rotaviral acute diarrhea was more frequently diagnosed in girls (p < 0.025), whereas bacterial - in boys (p < 0.044). The highest prevalence of acute rotaviral diarrhea was found in winter/spring, with peak in April. CONCLUSIONS: commonly used diagnostic procedure does not allow to establish the etiology of acute home diarrhea in children in most cases. Rotavirus is found in the majority of diagnosed cases. It seems reasonable to expand the spectrum of diagnostic tests in cases of acute diarrhea in children.

[Milk in the diet of children between 7 and 24 months of age]. / Mleko w diecie dzieci miedzy 7 a 24 miesiacem zycia.

THE AIM OF THIS STUDY: was to estimate what kind of milk is administrated to children between 7-23 months of age in Poland. MATERIAL AND METHODS: the study included 1390 children 13-36 months of age, from 4 different regions in Poland. Data were obtained on the basis of questionnaires filled in by mothers visiting the outpatient clinic. RESULTS: 16.7% of studied population were fed with human milk (9.l% only with human milk, 7.6% received both human milk and formula); 0.03% were fed with cow milk. Regional differences were observed. In the second year of life, 11.44% children were still given human milk, 60.3% -formula and 28.6% - cow milk. CONCLUSIONS: in Poland, only small percentage of children, older than 6 months, are still breastfed. Considering WHO recommendations, that children should be given human milk till 2nd year of age, breastfeeding recommendations are still to be promoted in our country.